State of Oklahoma
Rural Small Business Capital Company
526
Information Report
Revised 2011
For the Calendar Year Ending:
See Tax Credit Moratorium on page 2.
Federal Employer Identification Number
Corporation
Partnership
LLC
Name of Rural Small Business Capital Company
Address
Phone Number
City
State
Zip
Complete the applicable sections for investments made during this calendar year. Attach additional schedules if
necessary. Enclose a copy of the capital company’s annual financial statements, including documentation to
indicate the methods of operation and conduct of the business of the capital company. (*See note on Page 2)
A:
Entities Investing in the Rural Small Business Capital Company
Date of
Type of
Amount
Investment
Investment
Invested
Investor’s Name
Address
FEIN/SSN
1)
2)
3)
4)
B:
Entities Investing in Oklahoma Rural Small Business Ventures in Conjunction
with the Rural Small Business Capital Company
Business
Date of
Type of
Amount
Invested In
Investment
Investment
Invested
Investor’s Name
FEIN/SSN
FEIN
1)
2)
3)
C:
Oklahoma Rural Small Business Ventures in which Investments Were Made
by the Rural Small Business Capital Company
Name of Business
Date of
Type of
Amount
Invested In
Investment
Investment
Invested
FEIN
Type of Business
1)
2)
3)
This information return, including enclosures, must be filed by April 30th.
Under penalties of perjury, I declare I have examined this return, including accompanying statements, and to the best of my knowledge
and belief it is true, correct and complete.
Officer, General Partner or Member
Date
The Oklahoma Tax Commission is not required to give actual notice to taxpayer of changes in any state tax law.